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抗凝治疗相关异常子宫出血的管理:患者-临床医生视角。

Management of abnormal uterine bleeding on anticoagulation: the patient-clinician perspective.

机构信息

The Hemostasis and Thrombosis Center at Oregon Health & Science University, Portland, Oregon, USA; Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, Oregon, USA.

出版信息

J Thromb Haemost. 2024 Jul;22(7):1819-1825. doi: 10.1016/j.jtha.2024.04.002. Epub 2024 Apr 19.

Abstract

Bleeding is a well-recognized side effect of anticoagulant therapy, which is used to treat venous thromboembolism (VTE) in individuals of all ages, including those of female sex, who commonly experience VTE as a complication of hormonal therapies and/or pregnancy. Heavy menstrual bleeding (HMB) is also extremely common in reproductive-aged individuals of female sex. Despite these overlapping situations, relatively little attention has been paid to the impact of anticoagulant-associated HMB on treatment strategies and the patient experience. In this review, we summarize incidence and complications of HMB in anticoagulated individuals as well as management strategies for HMB in this population. We also address the patient experience, including the impact of HMB on quality of life and the impact of discontinuing hormonal therapies at the time of VTE diagnosis and anticoagulant initiation. We conclude by highlighting specific gaps related to the patient experience of anticoagulant-associated HMB in both the research and clinical settings.

摘要

出血是抗凝治疗的一种公认的副作用,抗凝治疗用于治疗各年龄段的静脉血栓栓塞症(VTE),包括女性,她们通常因激素治疗和/或妊娠而发生 VTE 作为并发症。大量月经过多(HMB)在生殖期的女性中也极为常见。尽管存在这些重叠情况,但相对较少关注抗凝相关 HMB 对治疗策略和患者体验的影响。在这篇综述中,我们总结了抗凝个体中 HMB 的发生率和并发症,以及该人群中 HMB 的管理策略。我们还讨论了患者体验,包括 HMB 对生活质量的影响,以及在 VTE 诊断和抗凝开始时停止激素治疗的影响。最后,我们强调了与研究和临床环境中抗凝相关 HMB 的患者体验相关的具体差距。

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